ANKUR PRAKASH BHAKTA DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****43

NOT RENEWED

N

DO

ANKUR

PRAKASH

BHAKTA

ANKUR PRAKASH BHAKTA DO

07/20/2017

07/20/2017

09/30/2020

SPRINGFIELD

IL

62769

SANGAMON

PRACTITIONER

II III IV V

N

01/14/2021